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Confusing (to me) iron studies--need help interpreting

Answered on August 19, 2014
Created May 25, 2012 at 4:41 PM

I recently had some blood work and was found to have mildly decreased RBCs (just below the lower end of normal). Prior to this set of lab results, I'd always been in the normal range (for blood work!). I had some followup iron labs drawn and got the results yesterday. I'm confused because I can't find anything that fits the combination of results that I have. They are:

Iron, total 119 (range 40-175 mcg/dL) Iron binding capacity 244 (range 250-450 mcg/dL) % saturation 49 (range 15-50%) ferritin 36 (range 10-232 ng/mL)

The RBCs were 3.7 (range 3.80-5.10 Million/uL)

Other information: Usually run low platelets, but not excessively low--they were 124,000 on this draw. MCH consistently is a little high--on this draw, value was 34.2 and the range is 27.0-33.0.

Nutritionally, I have been underweight and overweight--now I'm overweight and have been for about 2 years. I consume a lot of red meat.

In attempting to research this, I don't seem to fit iron deficiency or any other type of easily identified pattern. Anybody have any thoughts? Thanks in advance.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on September 08, 2012
at 01:17 AM

Transferrin is not an acute phase protein.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on September 08, 2012
at 01:17 AM

Transferrin is not an acute phase reactant.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on September 08, 2012
at 01:16 AM

Transferrin is not an acute phase protein.

C25ca23835e8b74e61979890f5c45c53

on May 26, 2012
at 07:52 AM

Transferrin is an acute phase protein, heightened in inflammation. Were you completely healthy when you did it?

C25ca23835e8b74e61979890f5c45c53

on May 25, 2012
at 07:45 PM

It's possible that you have just started to get the anemia of B12 or Folate deficiency. The MCV of 99 is a contradiction to Fe-deficiency as you already mentioned since they usually are hypochrome and microcytic. Did you do any Homocysteine and Methylmalonic acid test aswell? The B12 and B6 doesn't say a lot in it self. B12 can be high, low or normal in B12 deficiency. And a folate deficiency can be both quantatively and functionally low (with a normal value). One thing i forgot to ask, did you have anemia (what was your blood value)?

24868bf5aa2c49e269392765932d9dc4

(510)

on May 25, 2012
at 07:04 PM

Yes--but from what I read, TIBC should be high in iron-deficiency anemia and the TIBC is below the range. I agree with you that it doesn't sound like I"m iron deficient. Thanks for your input.

24868bf5aa2c49e269392765932d9dc4

(510)

on May 25, 2012
at 07:02 PM

Female, age 46, MCV 99.2 (r=80-100); MCH 34.2 (r=27-33), MCHC 34.5 (nml); RDW 13.7 (nml); B12 was measured several weeks ago and was smack dab in the middle of the range; B6 may be low (low end of nml last Fall--getting that redrawn tomorrow); WBC 6.1, H&H 13.0, 37.7 Thanks.

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2 Answers

1
4de2c59d682664a54cfcd4f0979e1115

on May 25, 2012
at 05:32 PM

What's the MCV?

Low MCH and MCV indicate iron-deficiency anemia. High MCH and MCV indicate folate and/or B12 deficiency. I agree that it doesn't sound like you are iron deficient. If you eat a lot of (red) meat, your B12 should be fine. Consider getting that checked (I was once deficient in B12 despite eating a lot of animal proteins), as well as folate.

24868bf5aa2c49e269392765932d9dc4

(510)

on May 25, 2012
at 07:04 PM

Yes--but from what I read, TIBC should be high in iron-deficiency anemia and the TIBC is below the range. I agree with you that it doesn't sound like I"m iron deficient. Thanks for your input.

C25ca23835e8b74e61979890f5c45c53

on May 26, 2012
at 07:52 AM

Transferrin is an acute phase protein, heightened in inflammation. Were you completely healthy when you did it?

121a16aded2bed8dca492d3c9662ef4c

(1327)

on September 08, 2012
at 01:16 AM

Transferrin is not an acute phase protein.

0
C25ca23835e8b74e61979890f5c45c53

on May 25, 2012
at 05:18 PM

Sex? Youd didn't get any MCV? Any reticulocytes measured?

Iron low

TIBC low

Transferrin Saturation normal

Ferritin normal (but on the lower edge)

Hyperchrome

Hard to tell by just these stats!

C25ca23835e8b74e61979890f5c45c53

on May 25, 2012
at 07:45 PM

It's possible that you have just started to get the anemia of B12 or Folate deficiency. The MCV of 99 is a contradiction to Fe-deficiency as you already mentioned since they usually are hypochrome and microcytic. Did you do any Homocysteine and Methylmalonic acid test aswell? The B12 and B6 doesn't say a lot in it self. B12 can be high, low or normal in B12 deficiency. And a folate deficiency can be both quantatively and functionally low (with a normal value). One thing i forgot to ask, did you have anemia (what was your blood value)?

24868bf5aa2c49e269392765932d9dc4

(510)

on May 25, 2012
at 07:02 PM

Female, age 46, MCV 99.2 (r=80-100); MCH 34.2 (r=27-33), MCHC 34.5 (nml); RDW 13.7 (nml); B12 was measured several weeks ago and was smack dab in the middle of the range; B6 may be low (low end of nml last Fall--getting that redrawn tomorrow); WBC 6.1, H&H 13.0, 37.7 Thanks.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on September 08, 2012
at 01:17 AM

Transferrin is not an acute phase protein.

121a16aded2bed8dca492d3c9662ef4c

(1327)

on September 08, 2012
at 01:17 AM

Transferrin is not an acute phase reactant.

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